title: Prolonged incubation time does not increase sensitivity for the diagnosis of implant-related infection using samples prepared by sonication of the implants.
abstract: We have designed a prospective study to evaluate the usefulness of prolonged incubation of cultures from sonicated orthopaedic implants. During the study period 124 implants from 113 patients were processed (22 osteosynthetic implants, 46 hip prostheses, 54 knee prostheses, and two shoulder prostheses). Of these, 70 patients had clinical infection; 32 had received antibiotics at least seven days before removal of the implant. A total of 54 patients had sonicated samples that produced positive cultures (including four patients without infection). All of them were positive in the first seven days of incubation. No differences were found regarding previous antibiotic treatment when analysing colony counts or days of incubation in the case of a positive result. In our experience, extending incubation of the samples to 14 days does not add more positive results for sonicated orthopaedic implants (hip and knee prosthesis and osteosynthesis implants) compared with a conventional seven-day incubation period.
authors.affiliation: IIS-Fundacion Jimenez Diaz, Department of Clinical Microbiology, Av. Reyes Catolicos 2, 28040 Madrid, Spain. jestebanmoreno@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Esteban
authors.forename: B
authors.initials: B
authors.lastname: Alvarez-Alvarez
authors.forename: A
authors.initials: A
authors.lastname: Blanco
authors.forename: R
authors.initials: R
authors.lastname: Fernández-Roblas
authors.forename: I
authors.initials: I
authors.lastname: Gadea
authors.forename: J
authors.initials: J
authors.lastname: Garcia-Cañete
authors.forename: E
authors.initials: E
authors.lastname: Sandoval
authors.forename: M
authors.initials: M
authors.lastname: Valdazo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046508:Culture Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000382:microbiology*; D011475:Prosthesis Failure / Q000209:etiology*; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000382:microbiology; D012680:Sensitivity and Specificity; D013010:Sonication / Q000379:methods*; D013997:Time Factors
keywords: Diagnosis; Implant; Incubation; Infection; Prolonged; Prosthetic-joint infection; Sonication